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Public Health Policies and Non-alcoholic Fatty Liver Disease

April 28, 2022

Non-alcoholic fatty liver disease (NAFLD) is a condition that is not well understood, yet a quarter of the global adult population is estimated to have NAFLD. Given the link between NAFLD and obesity, the prevalence of this disease is likely to continue to increase. NAFLD constitutes the second leading cause of liver transplantation in several high-income countries, including the USA. So far, the prevention and control of NAFLD has been almost entirely placed on the clinical field. Prevention and control typically uses intensive behavioral and pharmacological interventions usually targeting its risk factors (many overlap with those of other non-communicable diseases). These individual interventions have focused on individuals who are high-risk and not the entire population. Population-based approaches such as those derived from public health policies are more likely to lead to larger impact across the population and effectively decrease the public health burden of NAFLD.

Mariana Lazo, MD, PhD, ScM, associate research professor, Urban Health Collaborative was a co-author on an article published in Lancet Gastroenterology and Hepatology on, “The establishment of public health policies and the burden of non-alcoholic fatty liver disease in the Americas.” This study analyzed data from 17 American countries and found that none have an established national public health action plan focused on NAFLD, yet 35% of the countries had clinical guidelines on NAFLD. Examining the existence of individual policies focused on NAFLD-related risk factors or diseases, 88% of the countries had policies for the prevention of diabetes and 53% for the prevention of obesity.

There are multiple strategies and policies that could be developed to improve the prevention, screening, and treatment of NAFLD. These findings constitute a call for action and encourage the development of national policies against NAFLD and national guidelines to decrease the burden of NAFLD.

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